Periodic Reporting for period 1 - ISAC (International Study on Age-related disparity in Cancer patient survival)
Reporting period: 2019-07-22 to 2020-07-21
Specifically, the project aims at:
1 - Determining the contribution of comorbidities, treatment and stage at diagnosis on age-related disparities in colon and lung cancer survival in New Zealand and England;
2 - Determining the effect of social determinants notably socioeconomic position and ethnicity on age-related disparities in colon and lung cancer survival in New Zealand and England;
3 - Assessing the impact of eliminating age inequalities on colon and lung cancer survival to help inform health policymakers in England ).
In a second work, the fellow described the role of patient-related and clinical factors on age disparities in colon cancer survival among patients aged 50-99 years at diagnosis using New Zealand population-based cancer registry data linked to hospitalization data. Specifically, the fellow described the role of sex, ethnicity, socio-economic deprivation, emergency presentation, stage at diagnosis and comorbidity on the age difference in colon cancer survival. This work confirmed that survival decreased as the age at diagnosis increased, notably in advanced disease and missing stage. It showed that the excess mortality in older patients was minimal for localised cancers, maximal during the first six months for regional cancers, the first 18 months for distant cancers, and over the three years for missing stages. The age pattern of the excess mortality hazard varied according to sex for distant cancers, the route to diagnosis for regional and distant cancers, and comorbidity for cancer with missing stages. Overall, the results showed that factors reflecting timeliness of cancer diagnosis affected the most the difference in survival between middle-aged and older patients, probably by impacting treatment strategy. Because of the high risk of poor outcomes related to treatment in older patients, efforts made to improve earlier diagnosis in older patients are likely to help reduce age disparities in colon cancer survival in New Zealand.
The fellow started a similar analysis using lung cancer data.